Synergistic effect of myocardial injury and mid-regional proAdrenomedullin elevation in determining clinical outcomes of SARS-CoV-2 patients

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dc.coverageDOI: 10.3389/fmed.2022.929408
dc.creatorSpoto, Silvia
dc.creatorMangiacapra, Fabio
dc.creatorD’Avanzo, Giorgio
dc.creatorLemme, Daniela
dc.creatorBustos Guillén, César
dc.creatorAbbate, Antonio
dc.creatorMarkley, John Daniel
dc.creatorSambuco, Federica
dc.creatorMarkley, Roshanak
dc.creatorFogolari, Marta
dc.creatorLocorriere, Luciana
dc.creatorLupoi, Domenica Marika
dc.creatorBattifoglia, Giulia
dc.creatorCostantino, Sebastiano
dc.creatorCiccozzi, Massimo
dc.creatorAngeletti, Silvia
dc.date2022
dc.date.accessioned2025-11-18T19:56:32Z
dc.date.available2025-11-18T19:56:32Z
dc.description<p>Objective: Coronavirus disease 2019 (COVID-19) is a systemic disease induced by SARS-CoV-2 causing myocardial injury. To date, there are few data on the correlation between mid-regional proAdrenomedullin (MR-proADM) and myocardial injury. The aim of this study was to evaluate whether the association of myocardial injury and elevated mid-regional proAdrenomedullin values could predict mortality of SARS-CoV-2 patients, to offer the best management to COVID-19 patients. Materials and methods: All patients hospitalized for SARS-CoV-2 infection at the COVID-19 Center of the Campus Bio-Medico of Rome University were included between October 2020 and March 2021 and were retrospectively analyzed. Myocardial injury was defined as rising and/or fall of cardiac hs Troponin I values with at least one value above the 99th percentile of the upper reference limit (≥15.6 ng/L in women and ≥34.2 ng/L in men). The primary outcome was 30-day mortality. Secondary outcomes were the comparison of MR-proADM, CRP, ferritin, and PCT as diagnostic and prognostic biomarkers of myocardial injury. Additionally, we analyzed the development of ARDS, the need for ICU transfer, and length of stay (LOS). Results: A total of 161 patients were included in this study. Of these, 58 (36.0%) presented myocardial injury at admission. An MR-proADM value ≥ 1.19 nmol/L was defined as the optimal cut-off to identify patients with myocardial injury (sensitivity 81.0% and specificity 73.5%). A total of 121 patients (75.2%) developed ARDS, which was significantly more frequent among patients with myocardial injury (86.2 vs. 68.9%, p = 0.015). The overall 30-day mortality was 21%. Patients with myocardial injury presented significantly higher mortality compared to those without the same (46.6 vs. 6.8%, p &lt; 0.001). When dividing the entire study population into four groups, based on the presence of myocardial injury and MR-proADM values, those patients with both myocardial injury and MR-proADM ≥ 1.19 nmol/L presented the highest mortality (53.2%, p &lt; 0.001). The combination of myocardial injury and MR-proADM values ≥ 1.19 nmol/L was an independent predictor of death (OR = 7.82, 95% CI = 2.87–21.30; p &lt; 0.001). Conclusion: The study is focused on the correlation between myocardial injury and MR-proADM. Myocardial injury induced by SARS-CoV-2 is strongly associated with high MR-proADM values and mortality.</p>eng
dc.identifierhttps://investigadores.uandes.cl/en/publications/5f1ff211-4abd-4356-8d4f-5ce91889597d
dc.identifier.urihttps://repositorio.uandes.cl/handle/uandes/59847
dc.languageeng
dc.rightsinfo:eu-repo/semantics/openAccess
dc.sourcevol.9 (2022) date: 2022-10-26
dc.subjectCOVID-19
dc.subjectmid-regional proAdrenomedullin
dc.subjectmyocardial injury
dc.subjectSARS-CoV-2
dc.subjectTroponin I (tni)
dc.titleSynergistic effect of myocardial injury and mid-regional proAdrenomedullin elevation in determining clinical outcomes of SARS-CoV-2 patientseng
dc.typeArticleeng
dc.typeArtículospa
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